Archived: Dr Michael Cavendish Also known as The Hodford Road Surgery

Updated 24 April 2020

Dr Michael Cavendish (Hodford Road Surgery) is located at 73 Hodford Road, Golders Green, London, NW11 8NH. The provider is registered with CQC to deliver the Regulated Activities: diagnostic and screening procedures, maternity and midwifery, surgical procedures and treatment of disease, disorder or injury.

Dr Michael Cavendish is situated within the Barnet local authority and is one of 54 practices serving the NHS Barnet Clinical Commissioning Group area. The practice provides services to 3,823 patients.

The provider is a single-handed male GP and is supported by a clinical team made up of two male salaried GPs, two locum GPs (one male and one female), one female practice nurse and one female health care assistant. The clinical staff and patients were supported by a team of five non-clinical members of staff which included one practice manager.

The practice was open Monday to Friday from 8am to 6.30pm. Outside of these hours, patients were advised to access the pre-bookable hub appointments (available Monday to Friday from 6.30pm to 8pm and Saturday and Sunday from 8am to 8pm) or to contact NHS 111.

The patient population served by the practice has a higher than average number of patients under the age of 44. The practice has a lower number of patients aged 65 and over when compared to the national average. Of the patients registered at the practice, 81% are working or in full-time education, significantly higher than the local average of 66% and the national average of 61.9%.

Updated 24 April 2020

We carried out an announced comprehensive inspection at Dr Michael Cavendish (Hodford Road Surgery) on 14 November 2019. We decided to undertake an inspection of this service following our annual review of the information available to us.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as requires improvement overall. The key questions were rated inadequate for safe, requires improvement for effective and well-led and good for caring and responsive. Two of the six population groups were rated as requires improvement, the remaining four population groups were rated as good .

At this inspection we identified a breach of regulations 12 (safe care and treatment). We will carry out a focussed follow-up inspection within the next six months to ensure the practice is compliant with the regulations where breaches have been identified.

We rated the practice as inadequate for providing safe services because:

• Patient safety was put at risk because prescribing of high-risk medicines was not always in line with national guidance.

We rated the practice as requires improvement for providing effective services because:

• The system for managing staff training was not always effective and not all staff had completed annual mandatory training.
• The practice was performing above local and national averages for several clinical indicators. However, there was no clear plan in place to improve the poor uptake for childhood immunisations and cervical screening.

We rated the practice as requires improvement for providing well-led services because:

• There was a reasonable system of governance however some areas required improvement to ensure risks were identified and acted upon.

These areas affected two population groups, families children and young people and working age people (including those recently retired and students). These two population groups have been rated as requires improvement.

The remaining four population groups have been rated as good as detailed in the evidence table under the responsive and effective key questions.

We rated the practice as good for providing caring and responsive services because:

• Staff treated patients with dignity and respect.
• Patient feedback was positive about the service.
• The practice took account of the needs of its patients and made the service accessible.

The areas where the provider must make improvements are:

• Ensure national guidance is adhered to for the management of all high-risk medicines.

The areas where the provider should make improvements are:

• Ensure the systems used to manage staff training are effective and identify gaps in training requirements.

• Ensure there is a failsafe system in place for patients given two week wait referrals.
• Review current nursing provision at the practice with a view to improving clinical outcomes for patients.
• Ensure vaccine fridge temperature logs include minimum and maximum temperatures.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Updated 27 March 2017

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators was 87%, which was similar to the CCG average of 82% and the national average of 84%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 27 March 2017

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice’s uptake for the cervical screening programme was 81%, which was comparable to the CCG average of 79% and the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and child protection teams.

Updated 27 March 2017

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Admission avoidance care plan reviews were provided to support this population group.

• The practice offered health checks for those over 75.

Older patients received a written invitation for influenza and pneumonia vaccination.

Updated 27 March 2017

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

The practice encouraged its patients to attend national screening programmes for bowel and breast cancer screening; however the uptake was below the CCG and national average.

Updated 27 March 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups, voluntary organisations and had a counsellor available weekly in the practice.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 27 March 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless people and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.